Contrast-induced acute kidney injury and diabetic nephropathy.

Contrast-induced acute kidney injury (CIAKI) is a leading cause of iatrogenic renal failure. Multiple studies have shown that patients with diabetic nephropathy are at high risk of CIAKI. This Review presents an overview of the pathogenesis of CIAKI in patients with diabetic nephropathy and discusses the currently available and potential future strategies for CIAKI prevention.

Cognitive ability in early adulthood is associated with systemic inflammation in middle age: the Vietnam experience study.

We examined the prospective association between cognitive ability in early adulthood and erythrocyte sedimentation rate, a marker of inflammation, in middle age. Participants were 4256 male Vietnam era US veterans. Data on cognitive ability, assessed by the Army General Technical Test, ethnicity, and place of service were extracted from enlistment files.

Self-management counseling in patients with heart failure: the heart failure adherence and retention randomized behavioral trial.

Context: Motivating patients with heart failure to adhere to medical advice has not translated into clinical benefit, but past trials have had methodological limitations.

Objective: To determine the value of self-management counseling plus heart failure education, compared with heart failure education alone, for the primary end point of death or heart failure hospitalization.

Design, Setting, And Patients: The Heart Failure Adherence and Retention Trial (HART), a single-center, multiple-hospital, partially blinded behavioral efficacy randomized controlled trial involving 902 patients with mild to moderate heart failure and reduced or preserved systolic function, randomized from the Chicago metropolitan area between October 2001 and October 2004 and undergoing follow-up for 2 to 3 subsequent years.

Managing cardiac devices near the end of life: a survey of hospice and palliative care providers.

Implantable cardioverter defibrillators (ICDs) and pacemakers may change the character of an individual's eventual death. The objective of this study was to explore hospice and palliative care provider attitudes and experience in managing ICDs and pacemakers for patients near the end of life. A voluntary survey was distributed to session attendees at a national conference.

A special type of 'hard-to-reach' patient: experiences of pregnant women on methadone.

Introduction: Opiate addicts in New Zealand are a heterogeneous, hard-to-reach group with illicit drug activity as their common characteristic. This project investigated the experience of a specific hard-to-reach group: pregnant women with opiate dependency, focussing on their interactions with helping services and social networks. The aim was to explore the interactions of pregnant women on methadone with helping services and social support, with the objective to make recommendations to improve service to this 'hard-to-reach' group.

Synthesis and characterization of selective dopamine D2 receptor antagonists. 2. Azaindole, benzofuran, and benzothiophene analogs of L-741,626.

A series of indole, 7-azaindole, benzofuran, and benzothiophene compounds have been prepared and evaluated for affinity at D2-like dopamine receptors. These compounds share structural elements with the classical D2-like dopamine receptor antagonists haloperidol, N-methylspiperone and benperidol. Two new compounds, 4-(4-iodophenyl)-1-((4-methoxy-1H-indol-3-yl)methyl)piperidin-4-ol (6) and 4-(4-iodophenyl)-1-((5-methoxy-1H-indol-3-yl)methyl)piperidin-4-ol (7), were found to have high affinity to and selectivity for D2 versus D3 receptors.

Avian influenza virus H13 circulating in ring-billed gulls (Larus delawarensis) in southern Ontario, Canada.

Avian influenza virus (AIV) was studied in ring-billed gulls (Larus delawarensis) in one breeding colony on Lake Erie in 2000, and two on Lake Ontario in both 2000 and 2004. Antibodies to H13 AIV were detected in 92% of adults in 2000 and 82% in 2004. Antibody prevalence in 3-wk-old chicks was 5%-30% (overall 15%) in 2000 and 21% and 76% (overall 48%) in 2004.

A histopathological study of ovarian neoplasms in children in a tertiary hospital of northern Nigeria.

Background: Information concerning the frequency and pattern of ovarian tumours in children is scant, more so in northern Nigeria. In view of this, we reviewed ovarian biopsies obtained from children in Zaria over a 25-year period.

Materials And Methods: Ovarian tumours occurring in 48 patients of age 15 years and below were reviewed and classified using the current World Health Organization (WHO) histological classification of ovarian tumours.

Can a specialist parasitoid, Macrocentrus cingulum (Hymenoptera: Braconidae), influence the ecotype structure of its preferred host Ostrinia nubilalis (Lepidoptera: Crambidae)?

Synchronization between a parasitoid and its preferred host is an essential strategy for successful biological control. Two ecotypes of Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae) in North America are distinguished by their voltinism. In this study, the differential impact of a specialist parasitoid, Macrocentrus cingulum Brischke (Hymenoptera: Braconidae), on the univoltine and multivoltine populations of O.

Advanced heart failure and nocturnal hypoxaemia due to central sleep apnoea are associated with increased serum erythropoietin.

Aims: Central sleep apnoea (CSA) and increased serum erythropoietin (EPO) concentration have each been associated with adverse prognosis in heart failure (HF) patients. The aim of this study was to examine the relationship between nocturnal hypoxaemia due to CSA and the serum EPO concentration in patients with HF.

Methods And Results: Heart failure subjects (n = 33) and healthy controls (n = 18) underwent polysomnography (PSG) for diagnosis of CSA and identification and quantification of hypoxaemia.

Spontaneous "cardiomegaly" following pericardiectomy.

A 64-year-old woman presented eight days following pericardiectomy with a 2-day history of progressive dyspnea and new crushing chest pain. Chest x-ray revealed development of interval "cardiomegaly." Bedside echocardiography revealed a large accumulation of pericardial fluid despite absence of pericardium.

Regional and subcellular distribution of HDAC4 in mouse brain.

Histone deacetylases (HDACs) are part of a system that links epigenetic control of gene expression to a variety of environmental stimuli. Some HDACs, including HDAC4, shuttle between the cytoplasm and nucleus in response to physiological cues such as calcium signaling. HDAC4 mRNA is enriched in the brain, but the regional and subcellular protein expression pattern of HDAC4 is not known.

Obstructive sleep apnea and heart failure.

Obstructive sleep apnea (OSA) exerts several effects that may be particularly deleterious in patients with heart failure (HF). OSA should be considered especially in HF patients who are obese or have the metabolic syndrome, systemic hypertension, or pulmonary hypertension. HF patients in whom OSA is suspected should undergo a full evaluation by a sleep specialist, including a polysomnogram, to diagnose OSA and differentiate this disease from central sleep apnea.

Aspirin for the primary prevention of cardiovascular events: a systematic review and meta-analysis comparing patients with and without diabetes.

Objective: The negative results of two randomized controlled trials (RCTs) have challenged current guideline recommendations for using aspirin for primary prevention of cardiovascular events among patients with diabetes. We therefore sought to determine if the effect of aspirin for primary prevention of cardiovascular events and mortality differs between patients with and without diabetes.

Research Design And Methods: We conducted a systematic search of MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus since their inceptions until November 2008 for RCTs of aspirin for primary prevention of cardiovascular events.

A gene expression model of intrinsic tumor radiosensitivity: prediction of response and prognosis after chemoradiation.

Purpose: Development of a radiosensitivity predictive assay is a central goal of radiation oncology. We reasoned a gene expression model could be developed to predict intrinsic radiosensitivity and treatment response in patients.

Methods And Materials: Radiosensitivity (determined by survival fraction at 2 Gy) was modeled as a function of gene expression, tissue of origin, ras status (mut/wt), and p53 status (mut/wt) in 48 human cancer cell lines.

Obstructive sleep apnea and cardiovascular disease.

Purpose Of Review: To update the reader on the most recent developments linking obstructive sleep apnea to cardiovascular disease.

Recent Findings: Significant progress has been made in defining the relationship between obstructive sleep apnea and cardiovascular disease. However, much work remains to be done to clarify the pathophysiologic mechanisms and the potential role of treatment of sleep apnea in the prevention of cardiovascular morbidity and mortality.

Transcriptional effects of transfection: the potential for misinterpretation of gene expression data generated from transiently transfected cells.

Transfection is used to introduce a gene of interest into a cell. To interpret the downstream results, understanding which effects are the true biological responses to the gene and which, if any, are off-target effects can be difficult. In order to discriminate true biological effects from off-target effects, we transfected a breast cancer cell line, MCF7, with a vector encoding either a reporter gene or the identical vector without the reporter gene insert.

The incremental value of troponin biomarkers in risk stratification of acute coronary syndromes: is the relationship multiplicative?

Objective: To emphasize the importance of troponin in the context of a new score for risk stratifying acute coronary syndromes (ACS) patients. Although troponins have powerful prognostic value, current ACS scores do not fully capitalize this prognostic ability. Here, we weigh troponin status in a multiplicative manner to develop the TRACS score from previously published Rush score risk factors (RRF).

The cardiovascular intensive care unit nurse's experience with end-of-life care: a qualitative descriptive study.

Purpose: Nurses in the cardiovascular intensive care unit (CVICU) informally expressed moral angst when caring for patients who are approaching the end of life. The purpose of this study was to better understand CVICU nurses' perceptions about their roles and responsibilities in the decision-making process about change in intensity of care and end-of-life care for patients within the CVICU setting.

Participants And Methods: Nineteen nurses from one CVICU consented to being interviewed individually regarding their experiences caring for patients approaching the end of life, and specifically regarding the initiation of a change in code status.

Role of oxidative stress in contrast-induced acute kidney injury in diabetes mellitus.

Contrast-induced acute kidney injury (CIAKI) is the most-common form of in-hospital drug-induced acute kidney injury and occurs in 1 to over 50% of patients undergoing intravascular contrast media (CM) administration. Numerous risk factors for CIAKI have been described, the most prominent among them is pre-existing kidney disease such as diabetic nephropathy. The pathogenesis of CIAKI appears to be caused, at least in part, by renal vasoconstriction and renal ischemia leading to the generation of reactive oxygen species (ROS).

Implications of limiting CO2 concentrations for land use and energy.

Limiting atmospheric carbon dioxide (CO2) concentrations to low levels requires strategies to manage anthropogenic carbon emissions from terrestrial systems as well as fossil fuel and industrial sources. We explore the implications of fully integrating terrestrial systems and the energy system into a comprehensive mitigation regime that limits atmospheric CO2 concentrations. We find that this comprehensive approach lowers the cost of meeting environmental goals but also carries with it profound implications for agriculture: Unmanaged ecosystems and forests expand, and food crop and livestock prices rise.

Quality of life in a diverse population of patients with heart failure: BASELINE FINDINGS FROM THE HEART FAILURE ADHERENCE AND RETENTION TRIAL (HART).

Purpose: The exact role of psychosocial status in quality of life (QOL) of patients with heart failure (HF) is not fully clarified. This report investigates the association of depression and social support in 2 subdomains of QOL, overall satisfaction with QOL (S-QOL) and limitations in physical functioning (PF-QOL) in a diverse group of HF patients.

Methods: Baseline data were used from a behavioral clinical trial, with complete information on 695 HF patients, of whom 33% were black and 24% had diastolic dysfunction.

Exploration of Victoria crater by the Mars rover Opportunity.

The Mars rover Opportunity has explored Victoria crater, an approximately 750-meter eroded impact crater formed in sulfate-rich sedimentary rocks. Impact-related stratigraphy is preserved in the crater walls, and meteoritic debris is present near the crater rim. The size of hematite-rich concretions decreases up-section, documenting variation in the intensity of groundwater processes.

Neuropeptides modulate the heart of the stick insect Baculum extradentatum.

The dorsal vessel of the stick insect Baculum extradentatum consists of a tubular heart and an aorta that extends anteriorly into the head. Alary muscles, associated with the heart, are anchored to the body wall with attachments to the dorsal diaphragm. Alary muscle contraction draws hemolymph into the heart through incurrent ostia.